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84 Cards in this Set
- Front
- Back
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What is the pedicle?
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The base of the flap that contains the blood supply
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What is a local flap?
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A flap that shares a side with the defect
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What is a regional flap?
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the flap is near, but not immediately adjacent to the defect
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What is a distant flap?
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the flap is not near the defect
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What is a free flap?
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Free tissue transfer
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What is the best method of flap assessment?
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Clinical evaluation of temperature, color, cap refill, point bleeding and firmness
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What temperature should the flap be?
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body temperature
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What should capillary refill time of the flap be?
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2 seconds
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What is pin-point bleeding?
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Upon introduction of a fine gauge needle there should be bleeding and the blood should be red, not purple-blue
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What are signs of insufficient areterial supply to a flap?
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Cool, pallor (white), cap refill >2 seconds, slow or absent point bleeding, soft
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Describe the firmness of a healthy flap.
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soft, but with some appreciable turgor
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What are signs of insufficient venous return?
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warmer than expected, blue to purple hue, cap refill <2 seconds, brisk point bleeding with dark blood, tense and swollen
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What are some factors leading to vascular compromise of the flap?
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tight dressings, tight sutures, pressure from positioning, hematoma, kinking of flap or pedicle, cool ambient room temperature, nicotine, caffeine or other vasoconstrictors
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What is the Crane principle?
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A pedicled flap is used to lift, transport and deposit subcutaneous tissue from one place to another. After 10-21 days, the top portion of the flap is returned to the donor site
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What is an angiosome?
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A composite unit of skin and underlying tissue supplied by a source vessel.
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What is delay phenomenon?
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A flap is partially elevated and reset in a separate procedure before definitive flap elevation and transfer
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What are the benefits of delay?
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Changes in sympathetic tone, increased number of vessels in the flap (angiogenesis), dilation of previously present choke vessels, metabolic changes in the flap - increasing tolerance
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What is the time recommended between delay procedures?
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Usually 7-14 days
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What are the indications for a cutaneous flap?
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reconstruction of a local defect with similar, adjacent tissue, need for full-thickness tissue to cover relatively less vascular tissue (bone or tendon without periosteum/paratenon intact)
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What is the blood supply to the skin?
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direct cutaneous arteries, fasciocutaneous arteries and musculocutaneous arteries
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A groin flap is what type of flap?
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A
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A reverse superficial sural flap is what type of flap?
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A
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A radial forearm flap is what type of flap?
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B
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A scapular/parascapular flap is what type of flap?
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B
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A temporoparietal fascia flap is what type of flap?
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A
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A lateral arm flap is what type of flap?
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B
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A posterior interosseus flap is what type of flap?
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B
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A paramedian forehead flap is what type of flap?
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C
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A groin flap is used to correct what anatomic defects?
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abdominal wall, perineum, hand, forearm
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A reverse superficial sural flap is used to correct what anatomic defects?
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foot and heel
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A radial forearm flap is used to correct what anatomic defects?
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anterior, posterior forearm, elbow, upper arm
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A scapulr/parascapular flap is used to correct what anatomic defects?
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shouler, axilla, thoracic wall
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A temporoparietal fascia flap is used to correct what anatomic defects?
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Ear, ipsilateral face, FOM
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A lateral arm flap is used to correct what anatomic defects?
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anterior,posterior shoulder
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A posterior interosseus flap is used to correct what anatomic defects?
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elbow, antecubital fossa, proximal volar forearm
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A paramedian forehead flap flap is used to correct what anatomic defects?
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Nose, midface, forehead
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What is the blood supply to a groin flap?
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superficial circumflex iliac
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What is the blood supply to a reverse superficial sural flap?
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median superficial sural
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What is the blood supply to a radial forearm flap?
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radial
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What is the blood supply to a scapular/parascapular flap?
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circumflex scapular (transverse and descending) branches
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What is the blood supply to a temporoparietal fascia flap?
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superficial temporal
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What is the blood supply to a lateral arm flap?
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posterior radial collateral
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What is the blood supply to a posterior interosseus flap?
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posterior interosseus
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What is the blood supply to a paramedian forehead flap?
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supratrochlear, supraorbital
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What is a type I flap?
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one vascular pedicle
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What is a type II flap?
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One dominant pedicle and one or more minor pedicles
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What is a type III flap?
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2 dominant pedicles
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What is a type IV flap?
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segmental pedicles
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What is a type V flap?
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one dominant pedicle and several segmental smaller pedicles
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What is the difference between a type II and a type V flap
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In a type V, the flap can survive on the minor pedicles alone
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Give an example of a type I flap.
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Gastrocnemius, tnesor fascia lata
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Give an example of a type II flap.
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Biceps femoris, rectus femoris, soleus, gracilis
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Give an example of a type III flap.
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gluteus maximus, rectus abdominis, serratus anterior
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Give an example of a type IV flap.
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extensor hallucis longus sartorius, tibialis anterior
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Give an example of a type V flap.
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Latissimus dorsi, pectoralis major
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What type of flap is a gastrocnemius flap?
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type I
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What type of flap is a soleus flap?
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Type II
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What type of flap is a latissimus dorsi flap?
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Type V
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What type of flap is a pectoralis major flap?
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Type V
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What type of flap is a rectus abdominus flap?
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Type III
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What type of flap is a gluteus maximus flap?
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Type III
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What type of flap is a tensor fascia lata flap?
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Type I
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What type of flap is a gracilis flap?
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Type II
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What is the blood supply for a gastrocnemius flap?
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Sural
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What is the blood supply for a soleus flap?
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popliteal, posterior tibial, peroneal
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What is the blood supply for a latissimus dorsi flap?
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thoracodorsal
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What is the blood supply for a pectoralis major flap?
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throracoacromial
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What is the blood supply for a rectus abdominis flap?
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superior and deep inferior epigastric
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What is the blood supply for a gluteus maximus flap?
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superior and inferior gluteal
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What is the blood supply for a tensor fascia lata flap?
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lateral circumflex femoral (ascending branch)
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What is the blood supply for a gracilis flap?
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medial circumflex femoral
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A gastrocnemius flap is used for what anatomic areas?
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suprapatellar, knee, upper one-third tibia
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A soleus flap is used for what anatomic areas?
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middle, lower one-third of leg
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A latissimus dorsi flap is used for what anatomic areas?
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neck, occiput, parietal skull, face, chest, abdomen
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A pectoralis major flap is used for what anatomic areas?
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face to orbital rim, neck, chest, upper arm
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A rectus abdominis flap is used for what anatomic areas?
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anterior thorax, groin, perinuem, inferior trunk
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A gluteus maximus flap is used for what anatomic areas?
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sacrum, ipsilateral ischium
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A tensor fascia lata flap is used for what anatomic areas?
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lower abdominal wall, groin, perineum
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A gracilis flap is used for what anatomic areas?
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groin, perineum, vagina, anus, ischium
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Which of the following muscles is included in a facial artery musculomucosal flap?
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Buccinator
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Which of the following vessels is included in a submental flap?
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submental artery and vein
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which artiery supplies the myocutaneous flap?
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facial
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what is the major blood supply to the pec major flap?
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thoracoacromial artery
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what is the blood supply of the superficial inferior epigastric artery (SIEA) flap?
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superficial inferior epigastric (SIE) artery
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